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The most common causes include: Inadequate dietary intake (common in vegetarians/vegans) Malabsorption syndromes (e.g., celiac or Crohns disease) Atrophic gastritis Long-term use of acid-reducing medications Pernicious anemia (an autoimmune condition) B12 deficiency is one of the leading reversible causes of anemia

The consequences of NNMT inhibition over months or years are unknown

(PubMed) Hankey GJ

Age defying and antiageing IM injection or IV drip

Notes that high-dose niacin passes into breast milk and that lipid-altering doses could pose risks to nursing infants, recommending caution or avoidance of such doses during breastfeeding)